RESUMO
Los tumores epidermoides representan alrededor del 1 por ciento de todos los tumores intracraneales sindo el ángulo pontocerebeloso el sitio más frecuente de localización. La lesiones del IVto ventrículo son raras. Presentamos el caso de una paciente de 22 años que desarolló hidrocefalia condicionada por un tumor epidermoide del IVto ventrículo.
Epidermoid tumors account for 1 percent of intracranial neoplasms. They are usually found at the cerebello-pontine angle and location in the fourth ventricle is rare. We report the case of a 22-year-old woman with an epidermoid tumor of the fourth ventricle revealed by hydrocephalus.
Assuntos
Humanos , Feminino , Adulto , Carcinoma de Células Escamosas/cirurgia , Quarto Ventrículo , Cisto Epidérmico/cirurgia , Cisto Epidérmico/diagnóstico , HidrocefaliaRESUMO
Nasal obstruction is a frequent cause of referral to the ear, nose and throat specialist. When this symptom is resistant to medical management and common causes have been ruled out, the presence of neural structures should be investigated In the nasoethmoidal meningoencephalocele, a congenital defect of the ethmoid lamina cribrosa allows the herniation of the intracranial contents into the nasal fossa. The key to clinical diagnosis is the presence of nasal obstruction with rhinorrhea and recurrent meningitis. We describe the case of a 33-year old female who was long treated for nasal polyposis and underwent a successful surgical treatment of ethmoidal meningoencephalocele.
Assuntos
Encefalocele/diagnóstico , Seio Etmoidal , Meningocele/diagnóstico , Adulto , Doença Crônica , Encefalocele/complicações , Feminino , Humanos , Meningocele/complicações , Obstrução Nasal/etiologiaRESUMO
BACKGROUND: An endoscopic endonasal transsphenoidal approach is reported as less invasive, allowing an earlier discharge. Published series have never focused on its use in acromegalic patients. OBJECTIVE: To assess the effectiveness of an endoscopic endonasal transsphenoidal approach in the management of growth hormone-secreting adenomas. PATIENTS AND METHODS: Nineteen consecutively operated patients were assessed with a prospective follow-up of one year. RESULTS: Sex ratio was 0.7/1 and gross total removal was obtained in 16 cases (84%), subtotal in three (16%). The only complication was a cerebrospinal fluid leak requiring spinal drainage. The median in-hospital stay was 2.5 days. Sixteen patients experienced clinical improvement (84%) and no changes were observed in three (16%). Residual tumor was seen in two cases (11%). Growth hormone levels < 2 ng/dl were seen in 17 cases (89%) and only two patients (11%) had a level >2 ng/dl. Insulin-like growth factor-1 levels were normalized in 16 cases (84%) and remained elevated in three patients (16%). One patient presented an isolated elevated level of insulin-like growth factor-1. Patients with residual tumor and elevated growth hormone and insulin-like growth factor-1 levels underwent complementary radiosurgery. CONCLUSIONS: The endoscopic endonasal transsphenoidal approach seems to be useful in acromegaly, with a high rate of clinical and biochemical cure among other benefits.